An online survey clarifies some differences and similarities.
“Picky eaters” come in all sizes, ages, and genders. What they all have in common, however, is avoidance of new and familiar foods because of the food’s taste, smell, texture, or overall appearance.
How does picky eating differ from Avoidant/Restrictive Food Intake Disorder, or ARFID? ARFID is a relatively newly defined eating disorder, and while adults with ARFID have the same degree of depression, anxiety and obsessive-compulsive (OC) symptoms as those with anorexia or bulimia nervosa, their eating behaviors are quite different. In ARFID, restrictive eating leads to weight loss, nutritional deficiencies, dependence on nutritional supplements or enteral feeding, or psychosocial impairment but it cannot be attributed to entirely to concerns about weight or shape or to comorbid conditions.
University of Pennsylvania psychologists recently reported the results of the first study of ARFID symptoms secondary to picky eating in adults (J Eat Disord. 2016; 4:26). Drs. Hana F. Zickgraf, Martin E. Franklin, and Paul Rozin recruited 332 subjects using Amazon’s Mechanical Turk (MTurk), a website where workers are paid small amounts to complete online surveys. A second sample of 81 adults was recruited from posts to an online support group for adult picky eaters (Picky Eating Adults Support, or PEAS).
To differentiate picky vs non-picky eaters, the authors developed a questionnaire assessing the main criteria for a DSM-5 diagnosis of ARFID adapted from the SCID for DSM-5 (American Psychiatric Association, 2015). Participants were split into 4 groups: typical eaters (46.6%), picky eaters (32.8%), those with disordered eating attitudes (9.4%) and those with a diagnosis of ARFID (11.3%).
Higher levels of distress and impairment in ARFID patients
One major finding was that participants with ARFID had higher distress and impairment than did typical eaters and picky eaters without ARFID. A second finding is that adult picky eaters can be differentiated from typical eaters and adults with symptoms of AN and BN, based on rigid eating behaviors, food neophobia, and a pattern of eating from a list of 20 or fewer foods.
The researchers showed that symptoms of ARFID are relatively common among adult picky eaters who use the Internet, and very common in adult picky eaters who use the Internet for support. Those with symptoms of ARFID had eating-related impairment, internalizing distress, and OCD symptoms at levels comparable to those with disordered eating attitudes.